The authors studied 22 patients who had 32 feet with symptomatic talocalcaneal coalition. All feet were treated with excision of the bar and interposition of an autogenous free fat graft. These cases were assessed clinically and radiographically before and after the operation. They conclude that this technique is a good surgery with gratifying results. In the final outcome, 78.1% of feet became completely painless and 21.8% achieved relief of pain. There was improvement of the deformity in 68.7% and of range of motion in 75%.
Eight acetabula obtained from cadavers were studied to assess axial force strenght. Four of them were reinforced by a wire mesh and four others were tested without this reinforcement. We observed a significant increase in strenght in the group reinforced by wire mesh.
The difficulty of stabilizing hips with pathological dislocation or dysplasias, mainly in the sequelae of pyoarthritis where destruction of the head and neck of femur occurs with upward dislocation of the femur, is well known. In such cases, the stabilization methods for the hip are free bone grafts that often fail due to bone resorption and subsequent hip instability, and so arthrodesis is the only method of choice. Using our method good stabilization of the hip was achieved and mobility of the joint was preserved. In this series of 35 cases with a follow up of eight years after surgery, the Authors propose a new technique for the treatment of unstable hips with the use of a vascularized muscle pedicled bone graft. This technique can also be used in cases of Legg-Perthes disease, where the femoral head tends to partially dislocate.
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